Journal of perinatology : official journal of the California Perinatal Association
October 7, 2026 · via Europe PMC
Comparison of prenatal self-report of tobacco use to direct measurement of umbilical cord cotinine.
Mahabee-Gittens EM, Mack N, Bann CM, +13 more, Merhar SL
AI summary — for doctors, generated from the abstract only
Mothers' self-reported tobacco use substantially under-identifies prenatal exposure compared with umbilical cord cotinine testing.
What was studied
Secondary analysis of 179 pregnant women and their newborns (about half with prenatal opioid exposure), comparing self-reported tobacco or e-cigarette use with cotinine in umbilical cord tissue.
Key findings
- 53.1% of mothers reported tobacco or e-cigarette use, and cotinine was detected in 98.9% of these.
- Among 84 mothers reporting no use, cotinine was still detected in 34.5%.
- Agreement between self-report and biochemical result was moderate (Gwet's AC1 0.68).
Clinical relevance
Relying on self-report will miss many exposed newborns, which matters for counselling and for infants already at risk from opioids.
Who should care
Limitations
Secondary analysis of a mostly publicly insured sample, and cotinine can reflect secondhand smoke rather than active use, so it cannot separate the two.
Ask about household and community smoke exposure as well as personal use, and do not treat a negative self-report as reliable.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVE
This study compared maternal self-reports of prenatal tobacco product use with biochemically confirmed cotinine in umbilical cord tissue in newborns exposed to opioids in utero and unexposed controls.
STUDY DESIGN
Secondary data analysis on 179 pregnant women and newborns. Chi-square and t-tests were used to compare sociodemographic factors of those who did and did not self-report tobacco use.
RESULTS
Mean (SD) maternal age was 29.5 years (5.0); 85.2% had public insurance, and 92 (51.4%) took opioids prenatally. Ninety-five (53.1%) mothers self-reported prenatal tobacco product and/or e-cigarette use, with cord cotinine detected in 98.9%. Of the 84 reporting no use, cotinine detection was 34.5%, resulting in moderate agreement (Gwet's AC1 = 0.68 (0.571, 0.788), p < 0.001). Of those reporting no use, 27 (32.9%) had cotinine detected (p = 0.038).
CONCLUSIONS
Biochemically verified cotinine detection was much higher than maternal self-reports of prenatal tobacco use. Inquiring about household and community smoke exposure may help inform optimal care.
DOI
10.1038/s41372-026-02902-8
PMID
42844327
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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